磁共振胰胆管成像三维原始图及动态增强扫描在梗阻性黄疸中的诊断价值

The application of source image and Dynamic Enhanced MR imaging in demonstration of bile duct obstruction

目的评价磁共振胰胆管成像(MRCP)三维原始图与动态增强MRI检查在梗阻性黄疸中的应用价值。方法对132例梗阻性黄疸者常规进行MRI、MRCP扫描,可疑占位性病变患者进行动态增强MRI扫描。详细对比分析影像、手术及病理结果,分析MRCP的原始图、动态增强图象在诊断梗阻性黄疸中的价值。结果MRCP结合三维原始图像诊断良、恶性梗阻性黄疸与SSFSE序列的MRCP图像比较差异有显著性,前者明显优于后者(P<0.05)。MRCP结合常规MRI图像及动态增强MRI扫描诊断肝外恶性梗阻性黄疸与单纯SSFSE-MRCP图像差异亦有显著性(P<0.05)。单纯MRCP定性诊断准确率为84.9%,MRCP结合MRI原始图诊断准确率为93.9%。结论MRCP诊断梗阻性黄疸需要结合MRCP原始图及动态增强MRI。

Purpose To evaluate the application of source image and Dynamic enhanced MR imaging in demonstra- tion of bile duct obstruction. Methods Subjects was consisted of 132 patients with bile duct obstruction which were sur- gically and/or pathologically demonstrated. All subjects were underwent routine MRI scans, MRCP, Dynamic enhanced MR imaging, The comparative analysis were performed between the MRCP images and the surgical and pathological find- ings. Results The MRCP images combined with its raw images were superior to the MRCP images only in diagnosis of the bile duct obstructions （P〈0. 051）. The MRCP images combined with routine MRI and dynamic enhanced MR images were superior to the SSFSE sequence MRCP images only in diagnosis of malignant bile duct obstructions （P〈0.05）. The accuracy of the bile duet obstruction causes diagnosed by the MRCP images only and MRCP images combined with routine MR images were 84.9% and 93.9% respectively. Conclusion it is important that The MRCP images was combined with routine MRI and dynamic enhanced MR images in demonstration of bile duct obstruction.